Adnexal Skin Tumors in Zaria, Nigeria

Total Page:16

File Type:pdf, Size:1020Kb

Adnexal Skin Tumors in Zaria, Nigeria Annals of African Medicine Vol. 7, No.1; 2008: 6 – 10 Page | 6 ORIGINAL ARTICLE ADNEXAL SKIN TUMORS IN ZARIA, NIGERIA M. O. A. Samaila Department of Pathology, Ahmadu Bello University Teaching Hospital Shika –Zaria, Nigeria Reprint request to: Dr. M. O. A. Samaila, Department of Pathology, A. B. U.Teaching Hospital, Shika-Zaria, Nigeria. Email: [email protected] Tel: +234 803 5891007 Abstract Background: Adnexal skin tumors share many features in common and differentiate along one line. Their detailed morphological classification is difficult because of the variety of tissue elements and patterns seen. They may be clinically confused with other cutaneous tumors. The aim of this report is to review and classify all adnexal tumors seen in a pathology department over a 16year period. Method: A 16-year retrospective analysis of all adnexal skin tumors seen in a large University Teaching Hospital in Nigeria from January 1991- December 2006. All tissue specimens were fixed in 10% formalin, processed in paraffin wax and stained with Haematoxylin and Eosin. Histology slides were retrieved, studied and lesions characterized. Results: Fifty-two adnexal tumors were seen, accounting for 0.9% of all cutaneous tumors seen within the same period. The median age was 33years (range: 4days -70years). Clinical presentations varied from discreet swellings and nodules to ulcerated masses. Five patients presented with recurrent lesions. Only two cases had a clinical diagnosis of adnexal tumor. Twenty-four (46%) of the lesions were distributed in the head and neck region. Duration of symptoms was 2months to 15years (median: 12months). Tumours of the sweat gland were the commonest– 41(78.8%); they comprised predominantly eccrine acrospiroma(17), characterized histologically by solid nests of round to polygonal cells with clear to eosinophilic cytoplasm, forming tubules in areas. Tumours of sebaceous gland were 7 (13.5%); they comprised mainly Nevus sebaceous of Jadassohn (6), composed of immature sebaceous glands and pilar structures microscopically and a solitary sebaceous adenoma. Tumours of hair follicle were 4 (7.7%) and included trichoepithelioma, characterized microscopically by multiple horn cysts and epithelial tracts connecting abortive pilar structures and a trichofolliculoma. Forty-six lesions (88.5%) were benign and six (11.5%) malignant. Conclusion: Adnexal skin tumors have distinct histological patterns which differentiates them from other cutaneous tumors. They are commonly distributed in the head, neck and trunk. The commonest variants are those of eccrine sweat gland origin. Malignant adnexal tumors are uncommon in our setting. Key Words: Adnexal tumours, ecrine sweat gland Résumé Introduction: Adnezal tumeurs de la peau partagent pas mal de traits caractéristiques en commun et il y a des différences le long d’une ligne. Leur fiche de classification morphologique est difficile en raison de la variété des éléments des tissus et des tendances vues. Elles peuvent être cliniquement confondue avec d’autres tumeurs cutanées. L’objet de ce rapport est de passer en revue et de classifier tous les adnexal tumeurs vues dans un département de pathologie au cours d’une durée de 16 ans. Méthodes: Une analyse rétrospective d’une durée de 16 ans de l’assemble des tumeurs de la peau adnexal vues dans un grand centre hospitalier universitaire au Nigéria depuis janvier 1991 – décembre2006. Tous les spécimens des tissus ont été fixés dans un formol 10%, traité dans une paraffine solide et teintée avec l’hématoxyline et l’Eosine. Des plaques histologiques ont été retrouvées, étudiées, et les lésions caractérisées. Page | 7 Adnexal skin tumors. Samaila M. O. A. Résultats: Cinquante deux adnexal tumeurs ont été observées, ce qui représente 0,9% des tumeurs cutanées vues au cours de cette période. L’^âge médian était de 33 ans (groupe d’âge de 4 jours au 70 ans. Des présentations cliniques varient de gonflements et de nodules discret et des nodules aux masses ulcéreuses. Cinq patients présentaient des lésions récurrentes. Deux cas seulement ont eu un diagnostic clinique de adnexal tumeur. Vingt-quatre soit 46% des lésions ont été distribuées dans la région de la tête et du cou. La durée des symptômes était de 2 mois à 15 ans (médians: 12 mois). Tumeurs de la glande sudoripare sont les plus communs. 41 soit 78.8%, ils comprenaient essentiellement encrine acrospirome (17), caractérisée histologiquement par de solides nids de round à polygonal cellules claires à cosonophilic cytoplasme, formant des tubes dans les régions. Tumeurs des glandes sébacées étaient 7 soit 13.5%, ils comprenaient surtout de Nevus sébacées de Jadassohn (6), composé de glandes sébacées et immaturés structures de pilier au microscope et d’un adénome solitaire sébacées. Tumeurs du follicule pileux étaient 4 soit 7,7% et inclus trichoepitheliome, caractérisée microscopique ment par horn multiple kystes et appareil épithéliaux reliant des structures des piliers avortés et un une trichofolliculome. Quarante six lésions soit 88,5% sont bénignes et six soit 11,5% malignes. Conclusion: Adnexal tumeurs de la peau ont des schémas histologiques qui les différencie des autres tumeurs cutanées. Le plus souvent, ils sont distribués dans la tête, du cou et du tronc. Parmi les variantes sont celles des glandes sudoripares ecerine d’origine Adnexal tumeurs malignes sont rares dans notre milieu. Mots clés: Adnexal tumeurs, eccrine glandes sudoripares Introduction diastase resistant material in the cells and immunoreactivity with gross cystic disease fluid The adnexae is part of the epidermis of the skin and protein 15. is composed of different kinds of cells that can give rise to a wide variety of tumors.1-3 It is comprised of sweat glands, sebaceous glands and hair follicles, all Results of which share the same origin. Thus tumors arising from them share many features.1 Any detailed There were 52 adnexal tumors. During the same morphological classification of these tumors run into period, a total of 5642 cutaneous tumors were seen. difficulties owing to the variety of tissue elements There were 26 males and females each, aged 4days and patterns seen. The majority of these tumors are to 70years (median -33years). Two-peak age benign and are rarely malignant.4 This is a report of distributions (0-20years and 40-50years) were noted the histological patterns of adnexal tumors seen in a (Table 1). 16year period. Duration of symptoms was from birth to 15years (median 12months). Clinical presentations included discreet swellings (15), nodules (23), hypertrophic Materials and Methods surgical scar (1), polyps (6), ulcerations (3) and fungating masses (4). Five patients presented with All histologically diagnosed adnexal tumors at the recurrent lesions. Range of clinical diagnoses department of Pathology, Ahmadu Bello University included pyogenic granuloma 4 (7.7%), papilloma 6 Teaching Hospital Zaria, Nigeria from January 1991 to (11.5%), naevus 2 (3.8%), lipoma 3 (5.8%), December 2006 were reviewed. The tissue specimens hypertrophic scar 1 (1.9%), skin nodule 2 (3.8%), were received and fixed in 10% formalin and were foreign body granuloma 1 (1.9%) molluscum processed in paraffin wax. Histology sections stained contagiosum 2 (3.8%), chronic osteomyelitis 1 (1.9%), with routine Haematoxylin & Eosin (H&E) were hematoma 1 (1.9%), fibroma 8 (15.4%), cysts 5 retrieved and reviewed by the authors. Special stains (9.6%), liposarcoma 1 (1.9%), rhabdomyosarcoma 1 such as periodic acid schiff [PAS], Van Gieson and (1.9%), malignant melanoma 6 (11.5%) and Alcian blue were employed where required. squamous cell carcinoma 6 (11.5%). Only two cases The biodata, clinical history and anatomical sites had a clinical diagnosis of syringoma. There was no of lesions were obtained from patients’ positive family history of similar lesions in any of accompanying case cards. The tumors were grouped these patients. based on adnexae origin. Tumors were categorized on adnexea origin: The most reliable histopathologic criteria for Sweat gland 41 (78.8%), sebaceous gland 7 (13.5%) identifying malignant adnexal tumors are and hair follicle 4 (7.7%). Forty-six (88.5%) were decapitation secretion, periodic acid schiff positive benign and six (11.5%) malignant (Table 2). Page | 8 Adnexal skin tumors. Samaila M. O. A. Table 1. Distribution of 52 tumor and age Tumour Type 0-19 20-39 40-59 60+ Total (%) Benign Eccrine sweat gland Eccrine poroma 2 4 - - 6(11.5) Eccrine acrospiroma 5 3 8 1 17(32.7) Syringoma 2 2 - 1 5(9.6) Papillary syringoadenoma 1 - 1 - 2(3.8) Eccrine dermal cylindroma - 2 3 - 5(9.6) Sebaceous gland Nevus sebaceus of Jadassohn 4 2 - - 6(11.5) Sebaceous adenoma - - 1 - 1(2.0) Hair follicle Trichoepithelioma 2 - - 1 3(5.8) Trichofolliculoma 1 - - - 1(2.0) Malignant Sweat gland carcinoma - 1 4 1 6(11.5) Total 17 14 17 4 52(100) Sweat gland Sebaceous gland Benign sweat gland tumors comprised: eccrine The sebaceous tumors comprised mainly a solitary acrospiroma 17 (32.7%), eccrine poroma 6 (11.5%), sebaceous adenoma and six cases of nevus syringoma 5 (9.6%), eccrine dermal cylindroma 5 sebaceous of Jadassohn (NSJ). The NSJ showed (9.6%) and papillary syringoadenoma 2 (3.8%). immature sebaceous glands and pilar structures Eccrine acrospiroma was characterized histologically microscopically. by solid nests of round to polygonal cells with clear to eosinophilic cytoplasm, forming tubules in areas Hair follicle (Figure 1). Distribution was mainly in the trunk and Tumours of hair follicle included trichoepithelioma extremities. All five dermal cylindroma were confined (3; 5.8%), characterized microscopically by multiple to the scalp and microscopy showed tumor lobules horn cysts and epithelial tracts connecting abortive composed of epithelial cell nests separated by pilar structures and a trichofolliculoma (1; 2%). hyaline material in a loose stroma. Malignant variant Twenty-four (46.2%) cases were distributed comprised eccrine sweat gland carcinoma (6; 11.5%) between the scalp, face and neck, while 15 (28.8%) composed histologically of solid nests of large oval to were distributed on the trunk.
Recommended publications
  • Abstract Case Synopsis
    Volume 20 Number 4 April 2014 Case presentation Solitary papule over scalp 1 1 1 2 Nidhi Singh , Laxmisha Chandrashekar , Devinder Mohan Thappa , Rakhee Kar Dermatology Online Journal 20 (4): 6 1Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India 2Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India Correspondence: Laxmisha Chandrashekar Associate Professor, Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research Puducherry, India [email protected] Abstract Folliculosebaceous cystic hamartoma (FSCH) is a rare cutaneous hamartoma characterized by follicular, sebaceous, and mesenchymal elements. Folliculosebaceous cystic hamartoma is probably not as rare as previously thought and its inclusion in the differential diagnosis of asymptomatic skin colored papules or nodules is warranted, especially if it is present in the head and neck region. Key words: folliculosebaceous cystic hamartoma, sebaceous tumor Case synopsis A 33-year-old woman presented with an asymptomatic papule that had persisted for the past 11 years. She noticed slow growth in the size of the lesion over the past 5 years. Repeated trauma to the papule while combing her hair resulted in discomfort. Physical examination revealed a single non-tender, skin colored, firm, hairless papule of 5 x 4 x 3 mm diameter over the vertex of the scalp (Figure 1). It was excised and sent for histopathological examination (Figure 2, 3 & 4). Histopathological examination revealed a dilated follicular cystic structure with numerous sebaceous lobules radiating out from it in the dermis (Figure 2). The cyst showed a predominantly infundibular keratinization (Figure 3). This folliculosebaceous structure was surrounded by increased collagen in the dermis (Figure 2) and clefts were visible between the folliculosebaceous structures and the surrounding stroma (Figure 4).
    [Show full text]
  • Cutaneous Neoplasms
    torr CALIFORNIA TUMOR TISSUE REGISTRY 1 03RD SEMI-ANNUAL CANCER SEMINAR ON CUTANEOUS NEOPLASMS CASE HISTORIES 00•MODERAT.0RS: . PHILIP E. LE~0FJ', M.Q. Dir;ector O:f Oermatopafholo.gy ;Ser:Vice Associate Professor of Clinical Pathology U.C.S.F.- Elermatopa~hology San Francisco, ·californla and TIMGTH1f' H. MCG~WMON'f,, M ~D. Assistant Clinical Professor U.C~S.F. - Dermatopathology San Francisco, California December 7, 1997 Sheraton Palace Hotel San Francisco, California PLATFORM CHAIR: CLAUDE 0. BURDICK, M.D. Director of laboratory ValleyCare Health System Pleasanton, California CASE RISTORJES 10.3"" Semi-Annual Seminar (Due to in$uffient material, Case 115 is • compo~ite to two ca!ICll with an identical diagnosis, Ace. #15523 and Ace #12395.) Ca.c 1#1 - As:c 1#28070: The patient was a 12-ycaro{)ld male who had a fairly long history ofa very small bump in the scalp of the temporal area, which had recently become greally enlarged. The submitting denna!ologist mentioned that this was a soliwy lesion, with no other lesions apparent (Contributed by Prescott Rasmussen, MD.) c-111- As:c #11543: The patient was a 60-year-old Caucasian female wbo presented with a S.O em right suprapalellar subcutaneous mass which was reported to be present and gradually increasing in size for a period of approximately rn·o years. There was no history of prior trauma, and the remainder ofthe clinical history and physical findings wcze uoremarialble. An cxeisional biopsy was performed. The specimeD consisted ofa 4.S x 1.1 em elliptical segment ofeentnllly dimpled skin which surmowlted a S.3 x 4.4 x 3.6 em delicately encapsulated.
    [Show full text]
  • Trichoblastoma Arising from the Nevus Sebaceus of Jadassohn
    Open Access Case Report DOI: 10.7759/cureus.15325 Trichoblastoma Arising From the Nevus Sebaceus of Jadassohn Fatimazahra Chahboun 1 , Madiha Eljazouly 1 , Mounia Elomari 2 , Faycal Abbad 3 , Soumiya Chiheb 1 1. Dermatology Unit, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences, Casablanca, MAR 2. Plastic and Reconstructive Surgery, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences, Casablanca, MAR 3. Pathology, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences, Casablanca, MAR Corresponding author: Fatimazahra Chahboun, [email protected] Abstract Trichoblastoma is a rare benign skin adnexal tumour, belonging to the category of trichogenic tumours. The clinical and histological findings may often be confused with basal cell carcinoma, a malignant epidermal skin tumour. We report here a case of a 70-year-old man presented with a dome-shaped, dark-pigmented nodule within a yellowish hairless plaque on the scalp. The plaque had existed since childhood. However, the central pigmented nodule began appearing three months ago and enlarging gradually. The patient had no medical history. Furthermore the physical examination revealed a translucent, verrucous, and yellowish plaque, with central and pigmented nodule measuring 0.7 × 0.5 cm. Also basal cell carcinoma and trichoblastoma’s diagnosis were discussed. The patient was subsequently referred to the plastic surgery department, where he underwent a total excision. The histological examination was in favour of trichoblastoma arising from the nevus sebaceus. After 24 months of checking, no recurrence was observed. Trichoblastoma is a benign adnexal tumour. Its progression to malignant trichoblastoma (or trichoblastic carcinoma) is possible, but remains exceptional.
    [Show full text]
  • The Best Diagnosis Is: H&E, Original Magnification 2
    Dermatopathology Diagnosis The best diagnosis is: H&E, original magnification 2. a. adenoid cysticcopy carcinoma arising within a spiradenoma b. cylindroma and spiradenoma collision tumor c. microcysticnot change within a spiradenoma d. mucinous carcinoma arising within a spiradenoma Doe. trichoepithelioma and spiradenoma collision tumor CUTIS H&E, original magnification 100. PLEASE TURN TO PAGE 211 FOR DERMATOPATHOLOGY DIAGNOSIS DISCUSSION Amanda F. Marsch, MD; Jeffrey B. Shackelton, MD; Dirk M. Elston, MD Dr. Marsch is from the Department of Dermatology, University of Illinois at Chicago. Drs. Shackelton and Elston are from the Ackerman Academy of Dermatopathology, New York, New York. The authors report no conflict of interest. Correspondence: Amanda F. Marsch, MD, University of Illinois at Chicago, 808 S Wood St, Chicago, IL 60612 ([email protected]). 192 CUTIS® WWW.CUTIS.COM Copyright Cutis 2015. No part of this publication may be reproduced, stored, or transmitted without the prior written permission of the Publisher. Dermatopathology Diagnosis Discussion Trichoepithelioma and Spiradenoma Collision Tumor he coexistence of more than one cutaneous adnexal neoplasm in a single biopsy specimen Tis unusual and is most frequently recognized in the context of a nevus sebaceous or Brooke-Spiegler syndrome, an autosomal-dominant inherited disease characterized by cutaneous adnexal neoplasms, most commonly cylindromas and trichoepitheliomas.1-3 Brooke-Spiegler syndrome is caused by germline muta- tions in the cylindromatosis gene, CYLD, located on band 16q12; it functions as a tumor suppressor gene and has regulatory roles in development, immunity, and inflammation.1 Weyers et al3 first recognized the tendency for adnexal collision tumors to present in patients with Brooke-Spiegler syndrome; they reported a patient with Brooke-Spiegler syndrome with spirad- Figure 1.
    [Show full text]
  • Than Skin Deep: a Case of Nevus Sebaceous Associated with Basal Cell Carcinoma Transformation
    Open Access Case Report DOI: 10.7759/cureus.9386 More Than Skin Deep: A Case of Nevus Sebaceous Associated With Basal Cell Carcinoma Transformation Shauna Maty 1 , Kristen Salana 1 , Mihaela Radu 2 , Cristina Beiu 3 , Robert Hage 4 1. Dermatology, St. George's University School of Medicine, St. George, GRD 2. Dermatology, Emergency Clinical Hospital "Sf. Apostol Andrei", Constanta, ROU 3. Oncologic Dermatology, Elias Emergency University Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, ROU 4. Otolaryngology, St. George's University School of Medicine, St. George, GRD Corresponding author: Shauna Maty, [email protected] Abstract Nevus sebaceous is a congenital epidermal lesion that typically presents in infancy from the neck up and rarely undergoes malignant transformation. In patients who do present with malignancy, both RAS oncogene and PTCH tumor suppressor gene mutations have been implicated. We report an unusual case of nevus sebaceous in a 41-year-old male patient that developed into basal cell carcinoma on the forehead, and elaborate on the prolonged nature and unique location of its presentation. The case highlights the need for early intervention and how variable access to primary care can impact patient outcomes. We further explore the role of gene mutations in the circumstance that nevus sebaceous does become malignant, as well as pertinent differential diagnoses to consider. Categories: Dermatology, Genetics Keywords: nevus sebaceous, basal cell carcinoma, gene mutations, mosaicism, dermatology Introduction Nevus sebaceous is a type of rare congenital birthmark or skin hamartoma found in up to 0.3% of neonates that typically present from the neck up, most commonly found on the scalp.
    [Show full text]
  • Nevus Sebaceous
    Open Access Austin Journal of Pediatrics A Austin Full Text Article Publishing Group Review Article Nevus Sebaceous Alexander K. C. Leung1* and Benjamin Barankin2 Abstract 1Department of Pediatrics, University of Calgary, Canada 2Toronto Dermatology Centre, Canada Nevus sebaceous, a hamartoma of the skin and its adnexa, is characterized *Corresponding author: Alexander KC Leung, by epidermal, follicular, sebaceous, and apocrine gland abnormalities. Nevus Department of Pediatrics, The University of Calgary, sebaceous occurs in approximately 0.3% of all newborns. Both sexes are Pediatric Consultant, The Alberta Children’s Hospital, equally affected. The early infantile stage is characterized by papillomatous Calgary, Alberta, T2M 0H5, #200, 233 – 16th Avenue epithelial hyperplasia. The hair follicles are underdeveloped and the sebaceous NW, Canada, Tel: 403 230-3322; Fax: 403 230-3322; glands are not prominent. During puberty, sebaceous glands become numerous Email: [email protected] and hyperplastic, apocrine glands become hyperplastic and cystic, and the epidermis becomes verrucous. The hair follicles remain small and primordial Received: April 28, 2014; Accepted: May 26, 2014; and may disappear altogether. During adulthood, epidermal hyperplasia, large Published: May 27, 2014 sebaceous glands, and ectopic apocrine glands are characteristic histological findings. At birth, nevus sebaceous typically presents as a solitary, well- circumscribed, smooth to velvety, yellow to orange, round or oval, minimally raised plaque. The scalp and face are sites of predilection. Lesions on the scalp are typically hairless. At or just before puberty, the lesion grows more rapidly, becomes more thickened and protuberant, and at times acquires a verrucous or even a nodular appearance. Nevus sebaceous may be complicated by the development of benign and malignant nevoid tumors in the original nevus.
    [Show full text]
  • Current Diagnosis and Treatment Options for Cutaneous Adnexal Neoplasms with Apocrine and Eccrine Differentiation
    International Journal of Molecular Sciences Review Current Diagnosis and Treatment Options for Cutaneous Adnexal Neoplasms with Apocrine and Eccrine Differentiation Iga Płachta 1,2,† , Marcin Kleibert 1,2,† , Anna M. Czarnecka 1,* , Mateusz Spałek 1 , Anna Szumera-Cie´ckiewicz 3,4 and Piotr Rutkowski 1 1 Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; [email protected] (I.P.); [email protected] (M.K.); [email protected] (M.S.); [email protected] (P.R.) 2 Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland 3 Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; [email protected] 4 Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, 00-791 Warsaw, Poland * Correspondence: [email protected] or [email protected] † Equally contributed to the work. Abstract: Adnexal tumors of the skin are a rare group of benign and malignant neoplasms that exhibit morphological differentiation toward one or more of the adnexal epithelium types present in normal skin. Tumors deriving from apocrine or eccrine glands are highly heterogeneous and represent various histological entities. Macroscopic and dermatoscopic features of these tumors are unspecific; therefore, a specialized pathological examination is required to correctly diagnose patients. Limited Citation: Płachta, I.; Kleibert, M.; treatment guidelines of adnexal tumor cases are available; thus, therapy is still challenging. Patients Czarnecka, A.M.; Spałek, M.; should be referred to high-volume skin cancer centers to receive an appropriate multidisciplinary Szumera-Cie´ckiewicz,A.; Rutkowski, treatment, affecting their outcome.
    [Show full text]
  • Trichoblastic Carcinoma
    SM Journal of Clinical Pathology Case Report © Azevedo C. et al. 2020 Trichoblastic Carcinoma: A Case Report and Literature Review of an Extremely Rare and Diagnostically Challenging Cutaneous Malignancy of the Hair Follicle Chelsea Azevedo*, Joseph Varney, Karina Leyva, Matthew White, Nicole DiTommaso, Alexandria Kim, Emily Alimia, Cameron Volpe, and Mohamed Aziz Department of Pathology- American University of the Caribbean, School of Medicine, USA Abstract Trichoblastic carcinoma (TBC) is an extremely rare cutaneous malignancy of the hair follicle, first described in the literature in 1962 as a “primary neoplasm of the hair matrix” (1). Besides its rarity, TBC shares many clinical and histologic characteristics with basal cell carcinoma (BCC), making the diagnosis of TBC difficult to make. Many authors have described TBC as a malignant transformation of a benign trichoblastoma (TB), but a universal understanding of the pathophysiological origin of TBC has not been established (2, 3). We present a case of this uncommon tumor with the hope that this report will add to the small repertoire of available research, and aid clinicians in diagnosis and management of this rare tumor. Keywords: Trichoblastic, Carcinoma, Cutaneous, Basal cell carcinoma, Stroma, Hair follicle neoplasm. Mitosis Abbreviations TBC, it is important to distinguish TBC from other skin tumors with similar clinical presentations such as TB and BCC as TBC is : Trichoblastic Carcinoma. : Basal Cell Carcinoma. TBC BCC typically aggressive and has a high propensity to metastasize and TB: Trichoblastoma. TBCS: Trichoblastic Carcinosarcoma Introduction recurThis [11]. case represents an extremely rare entity with very few Trichoblastic carcinoma (TBC) is a rare malignant skin published cases and reports available.
    [Show full text]
  • Case Report Desmoplastic Trichilemmoma Arising in a Nevus Sebaceous: a Case Report
    Int J Clin Exp Pathol 2019;12(10):3953-3955 www.ijcep.com /ISSN:1936-2625/IJCEP0100551 Case Report Desmoplastic trichilemmoma arising in a nevus sebaceous: a case report Xiaojing An1, Yong Huang2 1Department of Pathology, Xiyuan Hospital CACMS, Beijing, China; 2Department of Pathology, PLA 81 Group Hospital, Zhangjiakou, China Received August 4, 2019; Accepted August 28, 2019; Epub October 1, 2019; Published October 15, 2019 Abstract: Nevus sebaceous is a congenital hamartoma of cutaneous structures, commonly associated with the development of secondary neoplasms. Desmoplastic trichilemmoma is characterized by the typical features of trichilemmoma (proliferation of columnar clear cells surrounded by cells forming a palisade resting on a thickened eosinophilic basement membrane) but contains a fibrous stroma with bands of epithelial cells, generally in the cen- tral zone. To the best of our knowledge, only 5 cases of desmoplastic trichilemmoma arising in a nevus sebaceous have been reported previously. Herein we report an unusual case of desmoplastic trichilemmoma arising in a nevus sebaceous and review the literature. Keywords: Desmoplastic trichilemmoma, nevus sebaceous, skin, neoplasms, fibrous stroma Introduction mild acanthosis and papillomatosis. Follicular dysgenesis and follicular induction were found. Trichilemmomas are benign adnexal skin Sebaceous glands were aberrantly placed, tumors related to the outer sheath of piloseba- some of the sebaceous glands were inserting ceous hair follicles, which is a lobular or plate- directly onto the epidermis, and also some fol- like growth of palisading clear cells with vari- licular induction was found. A superficial, well- able central keratinization. The cells are glyco- circumscribed, little solid tumor was also seen, gen-rich by PAS stain.
    [Show full text]
  • Epidemiological Study of Appendageal Skin Tumors in Tertiary Health Centre in Central India
    March- April, 2014/ Vol 2/ Issue 2 ISSN 2321-127X Research Article Epidemiological study of Appendageal skin tumors in tertiary health centre in central India Rathoriya SG 1, Soni SSL 2, Sinha U 3, Chanchlani R 4 1Dr Shyam Govind Rathoriya, Assistant professor, Department of Dermatology, 2Dr Sumit SL Soni, Senior Resident, Department of Dermatology, 3Dr Umesh Sinha Associate professor, Department of Community Medicine, 4Dr Roshan Chanchlani, Associate Professor, Department of Surgery. All are affiliated with Chirayu Medical College & Hospital, Bhopal, India Address for correspondence: Dr. Shyam Rathoriya, Email: [email protected] ............................................................................................................................................................................................................... Abstract Introduction: Cutaneous appendageal tumors are a large diverse group of tumors that are commonly classified according to their state of appendageal differentiation- eccrine, apocrine, follicular and sebaceous. Most appendageal tumors are relatively uncommonly encountered in routine clinical practice. Though some of the appendageal tumors (e.g. syringoma, nevus sebaceous) can be diagnosed clinically with ease but most of them have non-specific morphological appearance and their diagnosis is mainly based on histopathological characteristics. Material and methods: It was a cross sectional descriptive study conducted in the department of dermatology, Chirayu medical college and hospital, Bhopal. A total
    [Show full text]
  • ASCP. Cutaneous Adnexal Neoplasms: Classification and A
    1355 Cutaneous Adnexal Neoplasms: Classification And A Practical Diagnostic Approach David S. Cassarino, MD, PhD, FASCP WEEKEND OF PATHOLOGY AMERICAN SOCIETY FOR CLINICAL PATHOLOGY 33 W Monroe Ste 1600 Chicago, IL 60603 Program Content and Disclosure The primary purpose of this activity is educational and the comments, opinions, and/or recommendations expressed by the faculty or authors are their own and not those of the ASCP. There may be, on occasion, changes in faculty and program content. In order to ensure balance, independence, objectivity, and scientific rigor in all its educational activities, and in accordance with ACCME Standards, the ASCP requires all individuals in positions to influence and/or control the content of ASCP CME activities to disclose whether they do or do not have any relevant financial relationships with proprietary entities producing health care goods or services that are discussed in the CME activities, with the exemption of non-profit or government organizations and non-health care related companies. These relationships are reviewed and any identified conflicts of interest are resolved prior to the activity. Faculty are asked to use generic names in any discussion of therapeutic options, to base patient care recommendations on scientific evidence, and to base information regarding commercial products/services on scientific methods generally accepted by the medical community. All ASCP CME activities are evaluated by participants for the presence of any commercial bias and this input is utilized for subsequent CME planning decisions. The individuals below have responded that they have no relevant financial relationships with commercial interests to disclose: Course Faculty: David S.
    [Show full text]
  • A Rare Pigmented Variant of Trichoblastoma
    CASE REPORT Melanotrichoblastoma: A Rare Pigmented Variant of Trichoblastoma Erin E. Quist, MD; Dominick J. DiMaio, MD classification schemes for hair follicle neoplasms have been established based on the relative proportions of PRACTICE POINTS epithelial and mesenchymal components as well as stro- • Pigmented trichoblastoma is a histologic variant of mal inductive change, but nomenclature continues to trichoblastoma characterized by the presence of be problematic, as individual neoplasms show varying melanin pigment. degrees of differentiation that do not always uniformly • At least some pigmented trichoblastomas contain 1,2 melanocytes and have been referred to as mela- fit within thesecopy categories. One of these established 3 notrichoblastomas. categories is a pigmented trichoblastoma. An exceedingly rare variant of a pigmented trichoblastoma referred to as • The presence of melanocytes within pigmented 4 trichoblastomas should not be confused as melanotrichoblastoma was first described in 2002 and has representing an example of colonization or a colli- only been documented in 3 cases, according to a PubMed sion tumor. searchnot of articles indexed for MEDLINE using the term melanotrichoblastoma.4-6 We report another case of this rare tumor and review the literature on this unique Dogroup of tumors. Trichoblastomas are rare cutaneous tumors arising from the hair bulb and mesenchyme. Although they are benign, they can pose a Case Report diagnostic dilemma for the clinician and pathologist because they A 25-year-old white woman with a medical history clinically and histologically mimic more common lesions such as of chronic migraines, myofascial syndrome, and basal cell carcinomas (BCCs) and trichoepitheliomas. It is impor- tant for the clinician and pathologist to be aware of such tumors Arnold-Chiari malformation type I presented to derma- and their variants.
    [Show full text]